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Zhang W, Huang S, Ye Q, Wei D, Zhou X. Clinical efficacy of early and delayed loading implants: A systematic review and meta-analysis. J Prosthet Dent 2024; 132:343-353. [PMID: 35963711 DOI: 10.1016/j.prosdent.2022.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/20/2022]
Abstract
STATEMENT OF PROBLEM Whether early loaded implants have similar clinical outcomes to delayed loaded implants is unclear. PURPOSE The purpose of this systematic review and meta-analysis was to compare the outcomes of early and delayed loading dental implants. MATERIAL AND METHODS Comprehensive searches of the MEDLINE, EMBASE, and Ovid databases were enriched by hand searches. Only human randomized controlled trials (RCTs) that compared the clinical efficacy of early and delayed loading were included. The survival rates and marginal bone level (MBL) changes were pooled and analyzed by risk ratios (RRs) and weighted mean differences (WMDs), respectively. The subgroup analyses, which were based on the Mantel-Haenszel and inverse-variance methods, included the types of prosthesis, implant time, occlusion, number of missing teeth, operation methods, dental position, healing methods, and type of first restoration. A funnel plot was used for heterogeneity analysis. RESULTS Eighteen trials were included from the initial 601 articles. The dental implant survival rates for the early and delayed loading were similar (P>.05). Regarding the marginal bone level changes, the 2 loading protocols also reached a comparable clinical outcome (P>.05). CONCLUSIONS Early implant loading should achieve the same clinical efficacy as the delayed loading method.
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Affiliation(s)
- Wenhao Zhang
- Doctor, Department of Stomatology, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, PR China
| | - Sui Huang
- Doctor, Department of Pathology, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, PR China
| | - Qi Ye
- Doctor, Department of Stomatology, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, PR China
| | - Dixin Wei
- Doctor, Department of Stomatology, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, PR China
| | - Xincai Zhou
- Professor, Department of Stomatology, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, PR China.
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Vardić A, Puljak L, Galić T, Viskić J, Kuliš E, Poklepović Peričić T. Heterogeneity of outcomes in randomized controlled trials on implant prosthodontic therapy is hindering comparative effectiveness research: meta-research study. BMC Oral Health 2023; 23:908. [PMID: 37993826 PMCID: PMC10666438 DOI: 10.1186/s12903-023-03658-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 11/12/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Consistency in outcomes across clinical trials allows for comparing and combining results from different studies. A core outcome set (COS), representing a minimally agreed standardized group of outcomes that should be monitored and measured through research in a specific field of medicine, is not yet available for trials in implant prosthodontic (dental implant) therapy. This meta-research study aimed to analyze outcomes used in clinical trials on implant prosthodontic therapy. METHODS We searched the Cochrane Oral Health Group (COHG) register to identify systematic reviews of interventions in implant prosthodontic therapy published by October 2023. From the randomized controlled trials (RCTs) included in the relevant reviews, we extracted data on the characteristics of the included trials and the outcomes used. We categorized outcomes into domains. RESULTS From 182 systematic reviews in the COHG register, we included 11 systematic reviews on dental implant therapy. The reviews included 117 unique RCTs with 4725 participants, published from 1995 to 2020, which analyzed 74 different outcomes. Using different definitions, implant failure was analyzed in 73 RCTs. Seventeen RCTs did not define implant failure. Failure was most often (30 RCTs) followed up for one year. Only one RCT assessed implant failure after five years. Trials used 17 definitions of implant failure, while 17 trials did not report on the criteria of implant failure. Complications were analyzed in 48 RCTs, although they were not clearly defined in 12 RCTs. Failure of prosthodontic supra-structure was analyzed in 74 RCTs, with definitions of failure and criteria not clearly defined in 44 RCTs. Trials considered adverse events, peri-implant tissue health, patient attitudes, and other outcomes, including cost, aesthetics, or procedure duration. These outcomes were often different between trials. Twenty-six outcomes were used only once per study. CONCLUSIONS Clinical trials in implant prosthodontics used different outcomes, different definitions of outcomes and used different times to monitor them. Standardization of outcomes is necessary to allow comparability and evidence synthesis about the effectiveness of implant prosthodontic therapy.
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Affiliation(s)
- Ante Vardić
- Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | - Livia Puljak
- Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Zagreb, Croatia.
| | - Tea Galić
- Department of Prosthodontics, Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | - Joško Viskić
- Department of Fixed Prosthodontics, University of Zagreb School of Dental Medicine, Zagreb, Croatia
| | - Ena Kuliš
- Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | - Tina Poklepović Peričić
- Department of Prosthodontics, Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
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Marginal Bone Loss and Treatment Complications with Mandibular Overdentures Retained by Two Immediate or Conventionally Loaded Implants—A Randomized Clinical Trial. PROSTHESIS 2023. [DOI: 10.3390/prosthesis5010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
This study aimed to assess marginal bone loss and complication rates of mandibular overdentures retained on two implants with conventional and immediate loading protocols. Twenty edentulous patients were treated with mandibular two-implant-retained overdentures and new complete maxillary dentures. In one half of the sample, the implants were loaded immediately by VulkanLoc® abutments. In the counterpart group, these abutments were connected to the implants two months after implant placement (conventional protocol). Treatment outcomes were evaluated at 2, 6, and 12 months after implant placement. According to the pre- and post-insertion radiographs, there was a mean marginal bone loss of 0.25–0.59 mm (CI 95%) after 13.4 ± 2.1 months of follow-up. There were no significant differences between groups. The failure rate (percentage of implants failing per year) was slightly higher in the conventional loading group (14.0 ± 32.7%) than in the immediate loading group (8.3 ± 18.0%). The findings of the present study suggested that there were no differences in marginal bone loss observed at one year for immediately loaded implants (0.40–0.39 mm) versus conventionally loaded implants (0.44- 0.36 mm) placed for the retention of mandibular overdentures. There were no differences in primary and secondary stability of immediately loaded versus conventional implants; however, in the conventional loading group, stability increased significantly between implant placement compared at both 6 and 12 months post-placement.
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Nagay BE, Dini C, Borges GA, Mesquita MF, Cavalcanti YW, Magno MB, Maia LC, Barão VAR. Clinical efficacy of anodized dental implants for implant-supported prostheses after different loading protocols: A systematic review and meta-analysis. Clin Oral Implants Res 2021; 32:1021-1040. [PMID: 34352130 DOI: 10.1111/clr.13813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/10/2021] [Accepted: 07/06/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To summarize the clinical performance of anodized implants connected to different prostheses design after immediate/early (IL) or conventional loading (CL) protocols. MATERIALS AND METHODS Seven databases were surveyed for randomized (RCTs) and non-randomized controlled clinical trials (CCTs). Studies comparing IL vs. CL protocol of anodized implants supporting single crown, fixed partial denture (FPD), full-arch fixed dental prosthesis (FDP), or overdenture were included. Risk-of-bias was evaluated using Cochrane Collaboration tools. Meta-analyses for different follow-up were analyzed, followed by heterogeneity source assessment and GRADE approach. The outcomes included implant survival rate, marginal bone loss (MBL), implant stability quotient (ISQ), probing depth (PD), plaque index (PI), and peri-implantitis prevalence. RESULTS From 24 eligible studies, 22 were included for quantitative evaluation. Most RCTs (58%, n = 11) and all the 5 CCTs had high and serious risk-of-bias, respectively. Overall, pooling all prosthesis design, no difference between IL vs. CL protocols was observed for all outcomes (p > .05). However, according to prosthesis type subgroups, CL reduced MBL for full-arch FDP (p < .05). In a point-in-time assessment, with overdenture, although IL presented higher PI (12 months), it showed lower MBL (≥24 months), higher ISQ (3 months), and lower PD (6 and 12 months) (p < .05). Conversely, PD was higher for IL in single crown (3 and 6 months) (p < .05). Regarding MBL, IL demonstrated higher mean difference for full-arch FDP (36 months) and FPD (12 and 36 months) (p < .05). CONCLUSION Within the limitations of this study, overall, there is no significant difference in the outcomes between IL and CL loading protocols.
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Affiliation(s)
- Bruna Egumi Nagay
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Caroline Dini
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Guilherme Almeida Borges
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Marcelo Ferraz Mesquita
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Yuri Wanderley Cavalcanti
- Department of Clinic and Social Dentistry, Federal University of Paraiba (UFPB), João Pessoa, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Valentim Adelino Ricardo Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
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Borges GA, Costa RC, Nagay BE, Magno MB, Maia LC, Barão VAR, Mesquita MF. Long-term outcomes of different loading protocols for implant-supported mandibular overdentures: A systematic review and meta-analysis. J Prosthet Dent 2021; 125:732-745. [DOI: 10.1016/j.prosdent.2020.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 12/17/2022]
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Clinical Performance of a Novel Two-Piece Abutment Concept: Results from a Prospective Study with a 1-Year Follow-Up. J Clin Med 2021; 10:jcm10081594. [PMID: 33918898 PMCID: PMC8070442 DOI: 10.3390/jcm10081594] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/02/2021] [Accepted: 04/05/2021] [Indexed: 11/16/2022] Open
Abstract
Development of a stable and healthy soft-tissue barrier around dental implants is key to long-term success of implant-supported prostheses. The novel two-piece abutment concept shifts the prosthetic interface to the soft-tissue level to protect bone interface/connective tissue during the healing phase and restorative procedures. This prospective study included 72 patients treated with 106 implants to support a single-tooth or a three-unit bridge restored with two-piece abutments. The evaluation included marginal bone level change (MBLC), implant and prosthetic survival, soft-tissue health including keratinized mucosa height and mucosal margin position, patient quality of life (QoL) and satisfaction, and clinician satisfaction and ease-of-use rating of the concept. Mean MBLC from implant placement to 1 year was -0.36 ± 1.26 mm (n = 89), the 1-year implant and prosthetic survival rates were 97.1 and 96.7%, respectively, while keratinized mucosa height increased from 2.9 ± 1.2 mm at prosthetic delivery to 3.2 ± 1.3 mm, and mucosal margin migrated coronally by 0.49 ± 0.61 mm by 1 year. Patient satisfaction and QoL were high. Clinicians were satisfied with the esthetic and functional results and rated the concept as easy to use. In conclusion, the novel two-piece abutment concept promotes good peri-implant tissue health, while providing an easy-to-use workflow and high treatment satisfaction to both patients and clinicians.
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Pardal-Peláez B, Flores-Fraile J, Pardal-Refoyo JL, Montero J. Implant loss and crestal bone loss in early loading versus delayed and immediate loading in edentulous mandibles. A systematic review and meta-analysis. J Clin Exp Dent 2021; 13:e397-e405. [PMID: 33841740 PMCID: PMC8020311 DOI: 10.4317/jced.57966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 11/25/2020] [Indexed: 11/28/2022] Open
Abstract
Background Information about the risk of early loss and crestal bone loss of dental implants which have been loaded early is scant if compared with data available for those conventionally or immediately loaded. A meta-analysis of early loss and crestal bone loss in immediate or delayed loaded full mandibular denture retaining dental implants has been recently published. It is interesting to evaluate also the risks of early versus immediate and delayed loading in complete mandibular restorations. The purpose of this systematic review and meta-analysis was to study early (EL) versus immediate (IL) and delayed loading (DL) protocols in edentulous mandibles to determine whether differences exist in implant success and crestal bone loss.
Material and Methods The literature review was conducted in PubMed, Web of Science, and the Cochrane Library. Seven randomized clinical trials were included.
Results The result of a meta-analysis of implant loss before 1 year in EL versus IL was 0.34 (95% CI: 0.08, 1.52), favoring the EL control group, while the outcome for crestal bone loss at the three-year observation was -0.10 (95% CI: -0.28, 0.09), with a tendency toward reduced bone loss for EL. In the EL versus DL group, the result of the meta-analysis of implant loss before one year was inconclusive, while in the comparison regarding crestal bone loss in the first year of observation, the result was -0.03 (95% CI: -0.08,-0.02) with a tendency to less bone loss in EL.
Conclusions The risk of early implant loss in the IL group was higher than in the EL group. The results in terms of early implant loss in EL versus DL are inconclusive. Besides, crestal bone loss is greater in immediately and delayed loaded implants, at 1 and 3 years of observation, compared to those loaded early. Key words:Dental implants, early dental implant loading, dental prostheses, implant- supported, alveolar bone loss, meta-analysis.
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Affiliation(s)
- Beatriz Pardal-Peláez
- DDS, PhD. Associate professor. Faculty of Medicine. Dental Clinic. Department of surgery. Alfonso X St. 37007. University of Salamanca. Salamanca. Spain
| | - Javier Flores-Fraile
- DDS, PhD. Associate professor. Faculty of Medicine. Dental Clinic. Department of surgery. Alfonso X St. 37007. University of Salamanca. Salamanca. Spain
| | - José-Luis Pardal-Refoyo
- MD, PhD. Honorary collaborating professor. Faculty of Medicine. IBSAL (Salamanca Biomedical Research Institute) member. University assistance complex of Salamanca. Salamanca. Spain
| | - Javier Montero
- DDS, PhD. Lecturer of Stomatological Prosthesis. Faculty of Medicine. Dental Clinic. Department of surgery. Alfonso X St. 37007. University of Salamanca. Salamanca. Spain
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Ye M, Liu W, Cheng S, Yan L. Immediate vs conventional loading of mandibular overdentures: A comprehensive systematic review and meta-analysis of randomized controlled trials. J ORAL IMPLANTOL 2020; 48:64-73. [PMID: 33206979 DOI: 10.1563/aaid-joi-d-20-00265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Clinicians treating overdenture patients need to know if immediate loading and conventional loading results in similar outcomes. This study aimed to perform a systematic literature search of studies comparing immediate and conventional loading of mandibular overdentures irrespective of the number of implants and conduct a meta-analysis of implant failure and marginal bone loss (MBL). A literature search of PubMed, ScienceDirect, Ovoid, Springer, and Google Scholar databases was performed for randomized controlled trials (RCTs) comparing immediate vs conventional loading of mandibular overdentures. The primary outcome was implant failure and the secondary outcome was marginal bine loss (MBL). A descriptive analysis was performed for other outcomes. Thirteen trials were included. Only one trial compared the immediate and delayed loading of single implant-supported overdenture. Seven trials used two implants, one trial used three implants while four trials used four implants. Meta-analysis indicated no statistically significant difference in implant failure and MBL between immediate and conventional loading of two-implant and four-implant supported overdentures. Descriptive analysis indicated no difference in peri-implant tissue indices, implant stability, and quality of life outcomes between the two loading protocols.There may be no difference in implant failure and MBL with immediate loading or conventional loading of two and four-implant supported mandibular overdentures. Literature review indicates that there may be no difference in peri-implant tissue indices, implant stability, and QoL outcomes between the two loading protocols. The overall quality of evidence is moderate. Further, adequately powered RCTs are required to strengthen the evidence.
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Affiliation(s)
- Mingfu Ye
- Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment Department of Oral Implantology No. 1309, Lvling Road CHINA Xiamen Fujian 361008 Department of Oral Implantology, Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment
| | - Wenjun Liu
- Department of Oral Implantology, Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment
| | - Shaolong Cheng
- Department of Oral Implantology, Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment
| | - Lihui Yan
- Department of Oral Implantology, Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment
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Borges GA, Presotto AGC, Caldas RA, Pisani MX, Mesquita MF. Is one dental mini-implant biomechanically appropriate for the retention of a mandibular overdenture? A comparison with Morse taper and external hexagon platforms. J Prosthet Dent 2020; 125:491-499. [PMID: 32278498 DOI: 10.1016/j.prosdent.2020.01.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/27/2020] [Accepted: 01/27/2020] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM Limited information is available to clinicians on the use of dental mini-implants (MI) as opposed to standard-diameter implants (SDIs) for the stabilization of implant-retained mandibular overdentures (MOs). PURPOSE The purpose of this in vitro and finite element analysis study was to analyze and compare the biomechanical behavior of MOs with either 1 or 2 implants with external hexagon (EH), Morse taper (MT) SDIs, and MIs. MATERIAL AND METHODS Thirty photoelastic models (n=30) of each group (n=5) of SDIs (EH-1, EH-2, MT-1, MT-2) and MI (MI-1, MI-2) were fabricated for posterior, peri-implant, and total maximum shear stress evaluation by quantitative photoelastic analysis. One specimen of each group was further used to create the 6 computational models to be analyzed by finite element analysis. The maximum von Mises values and stress maps were plotted for each ductile component. Two types of load were applied to the overdenture: a150-N load bilaterally and simultaneously on the first molar and a 100-N load on the incisal edge of the central incisors at a 30-degree angle. The data were subjected to the 2-way ANOVA test and the Tukey honestly significant difference test (α=.05). RESULTS The EH-2 and MT-2 showed the lowest posterior (P<.001) and total (P<.05) mean shear stress values. For peri-implant shear stress, no difference was found among all groups (P>.05). Regardless of the loading area, the MI-1 and MI-2 groups showed the lowest von Mises stress values. However, for implant housing, the MI-1 group, under incisor loading, presented greater stress, followed by MT-1, EH-1, EH-2, MI-2, and MT-2. The attachment was the most overloaded structure, with high values under incisor loading, especially for the groups with 2 implants (MT-2, EH-2) as compared with the other models. CONCLUSIONS Biomechanically, regardless of the implant number, MI is a promising rehabilitation method with similar peri-implant shear stress and lower von Mises stress on the implant when compared with SDIs for MOs.
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Affiliation(s)
- Guilherme Almeida Borges
- Doctoral student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Anna Gabriella Camacho Presotto
- Research Fellow, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Ricardo Armini Caldas
- Professor, Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil.
| | - Marina Xavier Pisani
- Research Fellow, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Marcelo Ferraz Mesquita
- Full Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
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Kutkut A, Rezk M, Zephyr D, Dawson D, Frazer R, Al-Sabbagh M. Immediate Loading of Unsplinted Implant Retained Mandibular Overdenture: A Randomized Controlled Clinical Study. J ORAL IMPLANTOL 2019; 45:378-389. [PMID: 31389755 DOI: 10.1563/aaid-joi-d-18-00202] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This clinical study aimed to clinically and radiographically compare the implant survival rate and peri-implant tissue response between immediate and delayed loading protocols for unsplinted implant retained mandibular overdentures. Twenty patients were enrolled to participate in this study. Each subject was randomly assigned to 1 of 2 treatment groups: test group patients' implants (n = 10), which were immediately loaded, and control group patients' implants (n = 10), which were conventionally loaded. Locator abutments were torqued to 15 Ncm at delivery. Attachments were picked up intraorally immediately after implant placement for the test group and at 3 months for the control group, and 3-lb retention inserts were placed. Marginal bone levels based on cone beam computed tomography fixed reference points were recorded at baseline and 12 months. Modified plaque index, gingival index, and implant stability quotients were recorded at baseline, 3 months, and 12 months. After 12 months, implant survival rate was 100% in both groups. Marginal bone levels, keratinized mucosa, modified plaque index, and gingival index were significantly different among the groups at 3- and 12-month intervals, whereas no significant differences were found in implant stability quotients between the groups. The fact that implant survival rate was 100% in both treatment groups suggests that, within the limitations of this study, immediate loading protocol for unsplinted implant retained mandibular complete overdenture is as predictable, safe, and successful as the delayed loading protocol. Implementing the immediate loading protocol for mandibular implant retained overdentures could shorten treatment time, which could lead to better patient's satisfaction.
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Affiliation(s)
- Ahmad Kutkut
- Division of Restorative Dentistry, College of Dentistry, University of Kentucky, Lexington, Ky
| | - Mohamed Rezk
- Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, Ky
| | - Dominique Zephyr
- College of Public Health Public, University of Kentucky, Lexington, Ky
| | - Dolphus Dawson
- Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, Ky
| | - Robert Frazer
- Division of Prosthodontics, College of Dentistry, University of Kentucky, Lexington, Ky
| | - Mohanad Al-Sabbagh
- Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, Ky
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11
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Helmy MHED, Alqutaibi AY, El-Ella AA, Shawky AF. Effect of implant loading protocols on failure and marginal bone loss with unsplinted two-implant-supported mandibular overdentures: systematic review and meta-analysis. Int J Oral Maxillofac Surg 2018; 47:642-650. [PMID: 29146396 DOI: 10.1016/j.ijom.2017.10.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 10/21/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Abstract
The aim of this study was to compare implant failure and radiographic bone level changes with different loading protocols for unsplinted two-implant-supported mandibular overdentures. An electronic search of two databases (PubMed, Cochrane Library) was performed, without language restriction, to identify randomized controlled trials (RCTs) comparing immediate or early versus conventional dental implant loading protocols for unsplinted two-implant-supported mandibular overdentures. Data were extracted independently by two reviewers. The Cochrane tool was used to assess the quality of included studies. A meta-analysis was performed. Eight RCTs were identified, seven of which were included; one trial was excluded because related outcomes were not measured. Four of the seven studies were considered to have a high risk of bias and three an unclear risk. Meta-analysis revealed no difference between immediate versus conventional or early versus conventional implant loading protocols regarding implant failure (risk difference (RD) -0.02, 95% confidence interval (CI) -0.13 to 0.10; RD 0.09, 95% CI -0.03 to 0.20) or marginal bone loss (mean difference (MD) 0.09, 95% CI -0.10 to 0.28; MD -0.05, 95% CI -0.12 to 0.02) for implants supporting mandibular overdentures. These findings should be interpreted with great caution given the serious numerical limitations of the studies included.
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Affiliation(s)
- M H E-D Helmy
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt; Department Prosthodontics, Faculty of Dentistry, Assuit University, Assuit, Egypt
| | - A Y Alqutaibi
- Faculty of Oral and Dental Medicine, Ibb University, Ibb, Yemen; Department of Prosthodontics, Faculty of Dentistry, Ahram Canadian University, Cairo, Egypt.
| | - A A El-Ella
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - A F Shawky
- Removable Prosthodontics Department, Faculty of Dentistry, Beni Suef University, Beni Suef, Egypt
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Alfadda SA, Attard NJ. A cost analysis of a long-term prospective study of patients treated with immediately loaded implant-supported mandibular overdentures. Clin Implant Dent Relat Res 2017; 19:944-951. [DOI: 10.1111/cid.12519] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 06/07/2017] [Accepted: 06/26/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Sara A. Alfadda
- Department of Prosthetic Dental Sciences, College of Dentistry; King Saud University; Riyadh Saudi Arabia
- Department of Prosthodontics, Faculty of Dentistry; University of Toronto; Toronto Ontario Canada
| | - Nikolai J. Attard
- Department of Oral Rehabilitation and Community Care, Faculty of Dental Surgery; University of Malta; Msida Malta
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13
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Akoğlan M, Tatli U, Kurtoğlu C, Salimov F, Kürkçü M. Effects of different loading protocols on the secondary stability and peri-implant bone density of the single implants in the posterior maxilla. Clin Implant Dent Relat Res 2017; 19:624-631. [PMID: 28493347 DOI: 10.1111/cid.12492] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 04/18/2017] [Accepted: 04/19/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Immediate or early loading of dental implants becomes a clinically feasible concept. PURPOSE The aim was to evaluate the effects of different loading protocols (immediate, early, and delayed) on secondary stability and peri-implant bone density of single implants in the posterior maxilla. MATERIALS AND METHODS Thirty-nine implants (Dentium, South-Korea) were placed in 39 patients. After placement, implant stability values (ISQ) and baseline peri-implant bone density values derived from cone-beam computed tomography were recorded. Thirteen implants were included randomly in each loading groups. The secondary ISQ values were recorded during follow-up visits. Peri-implant bone density values were measured 1 year after placement again. Data was statistically analyzed. RESULTS Immediate-loaded group showed the lowest ISQ values, 1 month after placement. During the next follow-up visits, delayed-loaded group showed the lowest ISQ values while other groups showed comparable results. Early loading increased the peri-implant bone density greater than the other groups. CONCLUSIONS The peri-implant bone of early-loaded implants was significantly denser than that of immediate- and delayed-loaded implants, 1 year after placement. Density increment can be judged as the radiological findings of loaded-bone, which may also reduce the need for histomorphometric analysis of human biopsy to evaluate the bone reaction around the implants.
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Affiliation(s)
- Mücahide Akoğlan
- Department of Prosthodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Ufuk Tatli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Cem Kurtoğlu
- Department of Prosthodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Fariz Salimov
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Mehmet Kürkçü
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
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Elsyad MA, Khirallah AS. Circumferential bone loss around splinted and nonsplinted immediately loaded implants retaining mandibular overdentures: A randomized controlled clinical trial using cone beam computed tomography. J Prosthet Dent 2016; 116:741-748. [DOI: 10.1016/j.prosdent.2016.03.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 03/05/2016] [Accepted: 03/07/2016] [Indexed: 11/28/2022]
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Zhu Y, Zheng X, Zeng G, Xu Y, Qu X, Zhu M, Lu E. Clinical efficacy of early loading versus conventional loading of dental implants. Sci Rep 2015; 5:15995. [PMID: 26542097 PMCID: PMC4635353 DOI: 10.1038/srep15995] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 10/07/2015] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was to determine the clinical differences between early and conventional loading protocols for dental implants. A comprehensive search of the Medline, Embase, and OVID databases for studies published through January 10, 2015 was conducted. Fourteen studies were included in our analysis. We found that early loading imposed a significantly higher risk of implant failure than did conventional loading (risk ratio = 2.09, 95% confidence interval [CI] [1.18, 3.69], P = 0.01), while no significant differences between the methods were found with regards to the marginal bone loss (weighted mean differences [WMD] = 0.11, 95% CI [-0.07, 0.28], P = 0.23), periotest value (WMD = 0.02, 95% CI [-0.83, 0.87], P = 0.96), or implant stability quotient (WMD = 0.79, 95% CI [-0.03, 1.62], P = 0.06). As for the health status of the peri-implant tissue, conventionally loaded implants demonstrated better performance than did early loaded implants. Subgroup analyses demonstrated that the sample size, time of publication, loading definition, implant position, extent, and restoration type influenced the results. Although early implant loading is convenient and comfortable for patients, this method still cannot achieve the same clinical outcomes as the conventional loading method.
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Affiliation(s)
- Yanfei Zhu
- College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xinyi Zheng
- College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Guanqi Zeng
- College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yi Xu
- College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xinhua Qu
- Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Orthopaedic Implant, Shanghai, China
| | - Min Zhu
- Department of Oral and Cranio-Maxillofacial Science, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Eryi Lu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai, China
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16
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Sanz-Sánchez I, Sanz-Martín I, Figuero E, Sanz M. Clinical efficacy of immediate implant loading protocols compared to conventional loading depending on the type of the restoration: a systematic review. Clin Oral Implants Res 2015; 26:964-982. [PMID: 24917174 DOI: 10.1111/clr.12428] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Immediate loading has become a predictable option to restore all clinical situations. The aim of this systematic review was to assess whether immediate loading protocols achieve comparable clinical outcomes when compared to conventional loading protocols depending on the type of prosthetic restoration. METHODS A protocol was developed aimed to answer the following focused question: "What are the effects of immediate implant loading protocols compared to conventional implant loading, in terms of implant failure, marginal bone levels, and biological and mechanical complications based on the type of restoration?" The next subanalysis were performed as follows: the extent, type, and material of the restoration and the type of occlusal contact in function. This systematic review only included randomized controlled trials (RCTs) with a follow-up of at least 6 months after implant loading. RESULTS Thirty-seven final papers were included. The results from the meta-analyses have shown that the immediately loading implants demonstrated a statistically significant higher risk of implant failure [RR = 1.92; 95% CI (1.04; 3.54); P = 0.036], a statistically significant lower bone loss [WMD = 0.046; 95% CI (0.043; 0.049); P = 0.000] and a smaller increase in ISQ values [WMD = -1.096; 95% CI (-1.615; -0.577); P < 0.001, although both groups attained high survival rates (98.2% in the test and 99.6% in the control). Single teeth implants were greater risk of failure, when compared to immediately loaded full arch restorations (RR = 2 vs. 0.9), so as the occlusal pattern when compared to non-occlusal (RR = 1.9 vs. 1.4). CONCLUSIONS Immediate loading may impose a greater risk for implant failure when compared to conventional loading, although the survival rates were high for both groups.
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Affiliation(s)
| | | | - Elena Figuero
- Section of Graduate Periodontology, University Complutense, Madrid, Spain
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Mariano Sanz
- Section of Graduate Periodontology, University Complutense, Madrid, Spain
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
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Al-Sawai AA, Labib H. Success of immediate loading implants compared to conventionally-loaded implants: a literature review. ACTA ACUST UNITED AC 2015; 7:217-24. [DOI: 10.1111/jicd.12152] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 01/15/2015] [Indexed: 12/01/2022]
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18
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Engelhardt S, Papacosta P, Rathe F, Özen J, Jansen JA, Junker R. Annual failure rates and marginal bone-level changes of immediate compared to conventional loading of dental implants. A systematic review of the literature and meta-analysis. Clin Oral Implants Res 2014; 26:671-87. [DOI: 10.1111/clr.12363] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2014] [Indexed: 11/29/2022]
Affiliation(s)
| | - Petros Papacosta
- Department of Implantology and Periodontology; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - Florian Rathe
- Department of Prosthodontics and Biomaterials; Danube Private University; Krems Austria
- Private Practice; Forchheim Germany
| | - Jülide Özen
- Department of Prosthetic Dentistry; Private Dental Clinic; Aachen Germany
| | - John A. Jansen
- Department of Biomaterials; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - Rüdiger Junker
- Department of Prosthodontics and Biomaterials; Danube Private University; Krems Austria
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19
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Chrcanovic BR, Albrektsson T, Wennerberg A. Reasons for failures of oral implants. J Oral Rehabil 2014; 41:443-76. [PMID: 24612346 DOI: 10.1111/joor.12157] [Citation(s) in RCA: 239] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2014] [Indexed: 12/18/2022]
Abstract
This study reviews the literature regarding the factors contributing to failures of dental implants. An electronic search was undertaken including papers from 2004 onwards. The titles and abstracts from these results were read to identify studies within the selection criteria. All reference lists of the selected studies were then hand-searched, this time without time restrictions. A narrative review discussed some findings from the first two parts where separate data from non-comparative studies may have indicated conclusions different from those possible to draw in the systematic analysis. It may be suggested that the following situations are correlated to increase the implant failure rate: a low insertion torque of implants that are planned to be immediately or early loaded, inexperienced surgeons inserting the implants, implant insertion in the maxilla, implant insertion in the posterior region of the jaws, implants in heavy smokers, implant insertion in bone qualities type III and IV, implant insertion in places with small bone volumes, use of shorter length implants, greater number of implants placed per patient, lack of initial implant stability, use of cylindrical (non-threaded) implants and prosthetic rehabilitation with implant-supported overdentures. Moreover, it may be suggested that the following situations may be correlated with an increase in the implant failure rate: use of the non-submerged technique, immediate loading, implant insertion in fresh extraction sockets, smaller diameter implants. Some recently published studies suggest that modern, moderately rough implants may present with similar results irrespective if placed in maxillas, in smoking patients or using only short implants.
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Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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20
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Immediate loading of overdentures: systematic review. Oral Maxillofac Surg 2013; 18:259-64. [PMID: 23828272 DOI: 10.1007/s10006-013-0421-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Accepted: 06/20/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The goal of implant treatment is the formation of a direct bone-implant interface contact. PURPOSE This study aimed to evaluate the possibilities of immediate loading treatment for edentulous patients rehabilitated with mandibular and maxillary overdentures. MATERIAL AND METHODS A literature review using the PubMed and BIREME databases between the periods of 1977 and 2011 was performed. RESULTS From an initial yield of 218 titles, 78 articles were selected for text analysis, finally resulting in 23 studies (16 prospective, 6 prospective randomized, and 1 prospective multicenter) that met the inclusion criteria. CONCLUSION The immediate loading protocol through which the implants are subjected to occlusal function immediately after their placement was introduced to overcome this limitation.
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21
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Esposito M, Grusovin MG, Maghaireh H, Worthington HV. Interventions for replacing missing teeth: different times for loading dental implants. Cochrane Database Syst Rev 2013; 2013:CD003878. [PMID: 23543525 PMCID: PMC7156879 DOI: 10.1002/14651858.cd003878.pub5] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND To minimise the risk of implant failures after their placement, dental implants are kept load-free for 3 to 8 months to establish osseointegration (conventional loading). It would be beneficial if the healing period could be shortened without jeopardising implant success. Nowadays implants are loaded early and even immediately and it would be useful to know whether there is a difference in success rates between immediately and early loaded implants compared with conventionally loaded implants. OBJECTIVES To evaluate the effects of (1) immediate (within 1 week), early (between 1 week and 2 months), and conventional (after 2 months) loading of osseointegrated implants; (2) immediate occlusal versus non-occlusal loading and early occlusal versus non-occlusal loading; (3) direct loading versus progressive loading immediately, early and conventionally. SEARCH METHODS The following electronic databases were searched: the Cochrane Oral Health Group's Trials Register (to 8 June 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2012, Issue 4), MEDLINE via OVID (1946 to 8 June 2012) and EMBASE via OVID (1980 to 8 June 2012). Authors of identified trials were contacted to find unpublished randomised controlled trials (RCTs). There were no restrictions regarding language or date of publication. SELECTION CRITERIA All RCTs of root-form osseointegrated dental implants, having a follow-up of 4 months to 1 year, comparing the same implant type immediately, early or conventionally loaded, occlusally or non-occlusally loaded, or progressively loaded or not. Outcome measures were: prosthesis and implant failures and radiographic marginal bone level changes. DATA COLLECTION AND ANALYSIS Data were independently extracted, in duplicate, by at least two review authors. Trial authors were contacted for missing information. Risk of bias was assessed for each trial by at least two review authors, and data were extracted independently, and in duplicate. Results were combined using fixed-effect models with mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes with 95% confidence intervals (CI). A summary of findings table of the main findings was constructed. MAIN RESULTS Forty-five RCTs were identified and, from these, 26 trials including a total of 1217 participants and 2120 implants were included. Three trials were at low risk of bias, 12 were at high risk of bias and for the remaining 11 the risk of bias was unclear. In nine of the included studies there were no prosthetic failures within the first year, with no implant failures in 7 studies and the mean rate of implant failure in all 26 trials was a low 2.5%. From 15 RCTs comparing immediate with convential loading there was no evidence of a difference in either prosthesis failure (RR 1.87; 95% CI 0.70 to 5.01; 8 trials) or implant failure (RR 1.65; 95% CI 0.68 to 3.98; 10 trials) in the first year, but there is some evidence of a small reduction in bone loss favouring immediate loading (MD -0.10 mm; 95% CI -0.20 to -0.01; P = 0.03; 9 trials), with some heterogeneity (Tau² = 0.01; Chi² = 14.37, df = 8 (P = 0.07); I² = 44%). However, this very small difference may not be clinically important. From three RCTs which compared early loading with conventional loading, there is insufficient evidence to determine whether or not there is a clinically important difference in prosthesis failure, implant failure or bone loss. Six RCTs compared immediate and early loading and found insufficient evidence to determine whether or not there is a clinically important difference in prosthesis failure, implant failure or bone loss. From the two trials which compared occlusal loading with non-occlusal loading there is insufficient evidence to determine whether there is a clinically important difference in the outcomes of prosthesis failure, implant failure or bone loss. We did not identify any trials which evaluated progressive loading of implants. AUTHORS' CONCLUSIONS Overall there was no convincing evidence of a clinically important difference in prosthesis failure, implant failure, or bone loss associated with different loading times of implants. More well-designed RCTs are needed and should be reported according to the CONSORT guidelines (www.consort-statement.org/).
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Affiliation(s)
- Marco Esposito
- Cochrane Oral Health Group, School of Dentistry, The University of Manchester, Manchester, UK.
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22
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Suarez F, Chan HL, Monje A, Galindo-Moreno P, Wang HL. Effect of the Timing of Restoration on Implant Marginal Bone Loss: A Systematic Review. J Periodontol 2013; 84:159-69. [DOI: 10.1902/jop.2012.120099] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Nicu EA, Van Assche N, Coucke W, Teughels W, Quirynen M. RCT comparing implants with turned and anodically oxidized surfaces: A pilot study, a 3-year follow-up. J Clin Periodontol 2012; 39:1183-90. [DOI: 10.1111/jcpe.12022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Elena A. Nicu
- Department of Periodontology; Academic Centre for Dentistry Amsterdam; Amsterdam The Netherlands
| | - Nele Van Assche
- Department of Periodontology; Catholic University Leuven; Leuven Belgium
| | - Wim Coucke
- Department of Clinical Biology; Scientific Institute of Public Health; Brussels Belgium
| | - Wim Teughels
- Department of Periodontology; Catholic University Leuven; Leuven Belgium
| | - Marc Quirynen
- Department of Periodontology; Catholic University Leuven; Leuven Belgium
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A Comparative Study Between Early Occlusal Loading at 1 and 6 Weeks in Implant-Retained Mandibular Overdentures. IMPLANT DENT 2012; 21:242-7. [DOI: 10.1097/id.0b013e31824eeaa5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Cairo F, Sanz I, Matesanz P, Nieri M, Pagliaro U. Quality of reporting of randomized clinical trials in implant dentistry. A systematic review on critical aspects in design, outcome assessment and clinical relevance. J Clin Periodontol 2012; 39 Suppl 12:81-107. [DOI: 10.1111/j.1600-051x.2011.01839.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Francesco Cairo
- Department of Periodontology; University of Florence; Florence; Italy
| | - Ignacio Sanz
- Department of Periodontology; Universidad Complutense ; de; Madrid; Madrid; Spain
| | - Paula Matesanz
- Department of Periodontology; Universidad Complutense ; de; Madrid; Madrid; Spain
| | - Michele Nieri
- Department of Periodontology; University of Florence; Florence; Italy
| | - Umberto Pagliaro
- Department of Periodontology; University of Florence; Florence; Italy
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Assche N, Coucke W, Teughels W, Naert I, Cardoso MV, Quirynen M. RCT comparing minimally with moderately rough implants. Part 1: clinical observations. Clin Oral Implants Res 2011; 23:617-24. [DOI: 10.1111/j.1600-0501.2011.02256.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2011] [Indexed: 11/30/2022]
Affiliation(s)
- N. Assche
- Research Group for Microbial Adhesion Leuven; Department of Periodontology; Catholic University Leuven; Leuven; Belgium
| | - W. Coucke
- Department of Clinical Biology; Scientific Institute of Public Health; Brussels; Belgium
| | - W. Teughels
- Research Group for Microbial Adhesion Leuven; Department of Periodontology; Catholic University Leuven; Leuven; Belgium
| | - I. Naert
- BIOMAT Research Cluster; Department of Prosthetic Dentistry; Catholic University Leuven; Leuven; Belgium
| | - M. V. Cardoso
- BIOMAT Research Cluster; Department of Conservative Dentistry; Catholic University Leuven; Leuven; Belgium
| | - M. Quirynen
- Research Group for Microbial Adhesion Leuven; Department of Periodontology; Catholic University Leuven; Leuven; Belgium
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27
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Elsyad MA, Al-Mahdy YF, Fouad MM. Marginal bone loss adjacent to conventional and immediate loaded two implants supporting a ball-retained mandibular overdenture: a 3-year randomized clinical trial. Clin Oral Implants Res 2011; 23:496-503. [DOI: 10.1111/j.1600-0501.2011.02173.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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Vere J, Joshi R. Quality assessment of randomised controlled trials of dental implant surgery and prosthodontics published from 2004 to 2008: a systematic review. Clin Oral Implants Res 2011; 22:1338-45. [DOI: 10.1111/j.1600-0501.2010.02124.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Bilhan H, Mumcu E, Arat S. The Role of Timing of Loading on Later Marginal Bone Loss Around Dental Implants: A Retrospective Clinical Study. J ORAL IMPLANTOL 2010; 36:363-76. [DOI: 10.1563/aaid-joi-d-09-00078] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract
The aim of this study was to assess the relation between marginal bone loss (MBL) around dental implants after a loading period of 36 months and the timing of loading. A total of 87 patients with 252 implants were included in the study group. The time span from implant placement to beginning of loading of the implants was evaluated. Delay of loading of implants seems to increase MBL around dental implants as the result of disuse atrophy. Implants next to a tooth on 1 or 2 sides suffered less from MBL. No statistically significant difference in MBL rate was noted between single and splinted implants or between smooth collar and microgeometry neck implants. Results of this study encourage early loading, especially for the mandibular overdenture supporting implants.
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Affiliation(s)
- Hakan Bilhan
- Istanbul University, Faculty of Dentistry, Department of Prosthodontics, Istanbul, Turkey
| | - Emre Mumcu
- Istanbul University, Faculty of Dentistry, Department of Prosthodontics, Istanbul, Turkey
| | - Selda Arat
- Istanbul University, Faculty of Dentistry, Department of Prosthodontics, Istanbul, Turkey
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Alsabeeha N, Atieh M, Payne AGT. Loading protocols for mandibular implant overdentures: a systematic review with meta-analysis. Clin Implant Dent Relat Res 2010; 12 Suppl 1:e28-38. [PMID: 19438962 DOI: 10.1111/j.1708-8208.2009.00152.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mandibular overdentures are a successful treatment option for the edentulous patients with long-term predictable outcomes, using conventional loading protocols. Currently, both early and immediate loading protocols for mandibular implant overdentures are prevalent in the literature. PURPOSE A systematic review and meta-analysis of the current published literature on comparative studies using conventional versus either early and/or immediate loading protocols for mandibular implant overdentures. MATERIALS AND METHODS The review was carried out in accordance with the QUOROM (Quality of Reporting of Meta-Analyses) guidelines. The PICO (Population, Intervention, Comparisons, Outcomes) format was used in conjunction with predefined inclusion criteria. A literature search of PubMed (1969-October 2008), EMBASE (1998-October 2008), the Cochrane Database of Systematic Reviews, and the Cochrane Controlled Trial Register was conducted. In addition, hand searching through refereed dental journals was also performed for the years 2000 to 2008. The meta-analysis was conducted by using the MIX software v.1.7 (Kitasato Clinical Research Center, Kanagawa, Japan). RESULTS A total of 191 studies were identified through the electronic search. After full-text screening and cross-matching with the predefined inclusion criteria, only 10 studies with a minimum follow-up of 2 years were eligible for inclusion in this review. Of the 10 included studies, seven have compared the outcome of conventional versus early loading of implants supporting mandibular overdentures. The remaining three studies, on the other hand, compared the outcome of conventional versus immediate loading. The meta-analysis revealed no significant difference in the outcome between conventional and either early (p = .72) or immediate (p = .08) loading of implants supporting mandibular implant overdentures. CONCLUSIONS Short-term outcomes of early or immediate loading protocols for mandibular implant overdentures achieved comparable success to conventional loading ones. No evidence was found of long-term studies to support or refute either early or immediate loading protocols for mandibular implant overdentures.
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Affiliation(s)
- Nabeel Alsabeeha
- Sir John Walsh Research Institute, School of Dentistry, Dunedin, New Zealand
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Bahat O, Sullivan RM. Parameters for successful implant integration revisited part I: immediate loading considered in light of the original prerequisites for osseointegration. Clin Implant Dent Relat Res 2010; 12 Suppl 1:e2-12. [PMID: 20455902 DOI: 10.1111/j.1708-8208.2010.00279.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE With the increasing popularity and publication of loading implants at the time of placement, including at time of dental extraction and simultaneous with reconstructive procedures, the objective was to evaluate known variables identified for a traditional unloaded healing period and determine the applicability of these variables to immediate loading. MATERIALS A total of 124 published reports available as of January 2008 that contained information about loading from the time of surgery up to 3 months postsurgically were examined in light of published variables affecting osseointegration based on a 2 stage surgical approach. METHODS The articles were examined to differentiate between immediate loading (within the initial 48 hours) and early/delayed loading of implants. Success or survival criteria were noted, and where reasons for failure were available, categorized according to six variables considered as determinants for maintaining a long-term bone-to-implant contact. RESULTS Approximately 60 of the 124 reports described immediately loading implants within 48 with single-tooth, partial, and full-arch restorations, as well as implant overdentures. The implant success or survival rates ranged from 70.8% to 100%. Most studies considered implant survival to be the only criterion for success. CONCLUSIONS Of six parameters identified in 1981 as influencing osseointegration, two parameters (the status of the bone/implant site and implant loading conditions) appear to have diagnostic implications, whereas three (implant design, surgical technique, and implant finish) may affect immediate loading positively or adversely.
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32
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Esposito M, Grusovin MG, Achille H, Coulthard P, Worthington HV. Interventions for replacing missing teeth: different times for loading dental implants. Cochrane Database Syst Rev 2009:CD003878. [PMID: 19160225 DOI: 10.1002/14651858.cd003878.pub4] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND To minimize the risk of implant failure, osseointegrated dental implants are conventionally kept load-free during the healing period. During healing removable prostheses are used, however many patients find these temporary prostheses rather uncomfortable and it would be beneficial if the healing period could be shortened without jeopardizing implant success. Nowadays immediately and early loaded implants are commonly used in mandibles (lower jaws) of good bone quality. It would be useful to know whether there is a difference in success rates between immediately or early loaded implants compared with conventionally loaded implants. OBJECTIVES To evaluate the efficacy of (1) immediate (within 1 week), early (between 1 week and 2 months), and conventional (after 2 months) loading of osseointegrated implants, and of (2) immediate occlusal versus non-occlusal loading during the bone healing phase. SEARCH STRATEGY The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE were searched. Handsearching included several dental journals. Authors of all identified trials, an Internet discussion group and 55 dental implant manufacturers were contacted to find unpublished randomised controlled trials (RCTs). The last electronic search was conducted on 4 June 2008. SELECTION CRITERIA All RCTs of root-form osseointegrated dental implants, having a follow up of 4 months to 1 year, comparing the same implant type immediately, early and conventionally loaded or occlusally and non-occlusally loaded. Outcome measures were: prosthesis and implant failures and radiographic marginal bone level changes. DATA COLLECTION AND ANALYSIS Data were independently extracted, in duplicate, by two review authors. Authors were contacted for details of randomisation and withdrawals and a quality assessment was carried out. The Cochrane Collaboration's statistical guidelines were followed. MAIN RESULTS Thirty RCTs were identified and 22 trials including 976 participants in total were included. Twelve trials compared immediate versus conventional loading, three early versus conventional loading, six immediate versus early loading, and one occlusally versus non-occlusally loaded implants. On a patient, rather than per implant basis, there were no statistically significant differences for any of the meta-analyses. AUTHORS' CONCLUSIONS It is possible to successfully load dental implants immediately or early after their placement in selected patients, though not all clinicians may achieve optimal results. It is unclear whether it is beneficial to avoid occlusal contacts during the osseointegration phase. Trends suggest that immediately loaded implants fail more often than those conventionally loaded, but less commonly than those loaded early. If a clinician wishes to load the implants early, it might be wiser to load them immediately (within 1 week) rather than waiting for 1 or 2 months. A high degree of primary implant stability (high value of insertion torque) seems to be one of the prerequisites for a successful immediate/early loading procedure. More well designed RCTs are needed and should be reported according to the CONSORT guidelines (www.consort-statement.org/).
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Affiliation(s)
- Marco Esposito
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Manchester, Higher Cambridge Street, Manchester, UK, M15 6FH.
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TURKYILMAZ I, MCGLUMPHY EDWINA. Is there a lower threshold value of bone density for early loading protocols of dental implants? J Oral Rehabil 2008; 35:775-81. [DOI: 10.1111/j.1365-2842.2008.01867.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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